Games that Doctors Play Two-layered agency problems in a medical system

Medical doctors act as agents of their patients by either treating them directly or referring them to other more or differently specialized doctors, who thereby become "agents of agents". The main aim of this paper is to model central aspects of such two-layered agency relations in the medical sector. On the basis of our model, we draw some tentative conclusions concerning policy issues. In particular, we suggest relying on a strict separation of roles between diagnostic and therapeutic agents with counseling practitioners acting as gate-keepers of the medical system.